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The aim of the present study was to identify contextual factors related to smoking among urban African-American and White adolescents. We administered a survey assessing demographic and psychosocial variables to 299 adolescents in an urban pediatric clinic in the Midwest. Results indicated that being female, older age, lower academic performance, depressive symptoms, less frequent church attendance, parental smoking, and parental attitudes toward smoking were related to adolescent smoking. After controlling for demographics, the multivariate model predicting adolescent smoking included depressive symptoms, less frequent church attendance, and parental disapproval of smoking. Given these findings, efforts to decrease adolescent smoking may be enhanced by attending to depressive symptoms demonstrated by adolescents as well as contextual factors including parental attitudes and church attendance. [ABSTRACT FROM AUTHOR]

Presents a study to evaluate the association between receptivity to tobacco advertising and promotional activities and progress in the smoking uptake process. Question of whether tobacco advertising and promotion increases the likelihood that youths will begin smoking; Design; Setting and participants Main outcome measure; Results; Conclusion.

Background. Tobacco use is the leading preventable cause of disease and death in the United Stales. Among racial and ethnic minorities, disparities in tobacco use, knowledge of health risks and treatment resources, and access to and utilization of treatment contribute to a disproportionate disease burden from tobacco use. Furthermore, racial and ethnic minorities have been underrepresented within tobacco treatment studies. Purpose/Objective. This paper provides a review of published studies examining tobacco treatment interventions among ethnic and minority populations in the United States. Study Design/Methods. Literature searches were used to identify smoking cessation interventions involving racial/ethnic minority populations. Identified studies were published between 1985 and 2009 involving African-American, Latino, Native American, and Asian or Pacific Islander smokers. Studies included in the review (1) targeted one or more ethnic minority group or had at least 10% of study participants from ethnic minority groups and (2) reported abstinence outcomes. Results. Sixty-four studies were included in this review. Of studies meeting inclusion criteria, 28 included a primary focus on African-Americans, 10 focused on Latinos, 4 focused on Native Americans, and 3 focused on Asian-American smokers. An additional 19 studies reported samples including participants from more than one minority group. Sample inclusion criteria, intervention content and duration, follow-up, abstinence assessment, and limitations of these studies were reviewed. Conclusions. Individuals from racial and ethnic minority populations are interested in stopping smoking and willing to participate in treatment research. Variations in the content of treatment intervention and study design produced a range of abstinence out comes across studies. Additional research is needed for all groups, including African-American smokers, and special attention is warranted for Latino, Native American, and Asian groups given the paucity of published studies. Although there were limited evaluations of pharmacotherapy, the existing data support use of pharmacotherapy in addition to counseling for enhancing abstinence outcomes. Further attention to level of individual smoking, variability in smoking patterns, and use of other tobacco products is needed, given known variation within and between racial and ethnic groups. Overall, findings are consistent with recommendations from the 2008 Clinical Practice Guidelines calling for increased research devoted to evaluating and enhancing tobacco use treatment interventions among racial and ethnic minority populations. [ABSTRACT FROM AUTHOR]

Introduction: Prevalence of cigarette smoking is highest among American Indians, yet few culturally appropriate smoking cessation programs have yet been developed and tested for multi-tribal American Indian adult populations. This study examined implementation of the All Nations Breath of Life culturally tailored smoking cessation program in multi-tribal urban and suburban American Indian communities in seven locations across five states (N = 312).Methods: This single-arm study used community-based participatory research to conduct a 12-week intervention whose primary purpose was to curb commercial tobacco use among American Indians. Participants were followed through month 6 in person and month 12 via telephone. The primary outcome was continuous abstinence from recreational cigarette smoking at 6 months post-baseline, verified through voluntary provision of salivary cotinine levels.Results: At program completion (12 weeks post-baseline), 53.3% of program completers remained abstinent; labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline (primary endpoint), 31.1% of retained participants quit smoking (p < .0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% labeling those lost to follow-up as smokers (p = .002). Retention rate at endpoint was 71.2%. 12-month follow-up was attempted with all participants and had a retention rate of 49.0%. Of those participants reached, 34.0% were smoke-free.Conclusions: All Nations Breath of Life shows promise as a smoking cessation program for multi-tribal urban American Indian communities. It can be successfully implemented in a variety of urban settings.Implications: This is the first large feasibility study of a culturally tailored smoking cessation program for American Indians with good cessation and retention rates in a multi-tribal urban American Indian population. It shows that All Nations Breath of Life can be implemented in multiple urban settings across five states. To our knowledge, this is the first program of its kind to be implemented across multiple heterogeneous urban locations and to include salivary cotinine testing for verification of self-report data across these locations. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: American Indians (AI) have the highest smoking rates of any racial/ethnic group in the U.S. and have more difficulty quitting smoking. Little is known about the smoking characteristics of AI smokers. The present study compared the demographic and smoking characteristics of light (≤10 cigarettes per day; N=206) and moderate/heavy (11+ cigarettes per day; N=86) AI smokers participating in a cross-sectional survey about smoking and health. Methods: Multiple methods were used to recruit participants in attendance at powwows, health and career fairs, and conferences. A total of 998 AI (76% cooperation rate) completed a survey assessing general health, sociodemographics, traditional and commercial tobacco use, knowledge and attitudes related to cancer, source of health information and care and other health-related behaviors. Results: AI light smokers were younger and less likely to be married or living with a partner compared to moderate/heavy smokers. AI light smokers were less dependent on smoking and more likely to have home smoking restrictions. There were no differences with respect to number of quit attempts in the past year or the average length of their most recent quit attempt by light vs. moderate/heavy smoking. In addition, a similar proportion of light and heavy smokers reported using tobacco for traditional purposes such as ceremonial, spiritual and prayer. Conclusions: These findings highlight important differences between AI light and heavier smokers. Differences related to smoking characteristics such as level of dependence and home smoking restrictions have important implications for the treatment of AI smokers. [Copyright &y& Elsevier]

Background Previous research demonstrated the efficacy of sustained release bupropion (bupropion SR) for smoking cessation in whites as well as moderate to heavy (≥10 cigarettes per day [CPD]) African American smokers. We evaluated whether bupropion SR was effective for smoking cessation among African American light smokers (≤10 CPD). Methods A randomized, double-blind placebo-controlled trial was conducted from December 27, 2007, to May 13, 2010. All participants were African American light smokers (≤10 CPD), aged 18 years or older. Participants were randomly assigned to receive 300 mg bupropion SR (150 mg once daily for 3 days and then 150 mg twice daily) (n = 270 participants) or placebo (n = 270 participants) for 7 weeks, and up to six sessions of health education counseling. Serum cotinine was measured at baseline (week 0). The primary outcome was salivary cotinine–verified 7-day point prevalence smoking abstinence at week 26; a cut point of 15 ng/mL differentiated smokers from nonsmokers. Salivary cotinine–verified smoking abstinence at end of medication treatment at week 7 was also examined. Odds ratios (OR) for smoking abstinence and 95% confidence intervals (CIs) were calculated using logistic regression models. All statistical tests were two-sided. Results Participants at baseline visit (week 0) smoked an average of 8.0 CPD and had a mean serum cotinine level of 275.8 ng/mL (SD = 155.8 ng/mL); most used menthol cigarettes (83.7%) and smoked within 30 minutes of waking (72.2%). After imputing those lost to follow-up as smokers, no statistically significant difference in long-term smoking abstinence rates at week 26 was observed between bupropion SR and placebo groups (13.3% vs 10.0%, OR = 1.39, 95% CI = 0.82 to 2.35, P = .23). Cotinine-verified smoking abstinence rate at end of medication week 7 was higher in the bupropion SR vs placebo group (23.7% vs 9.6%, OR = 2.92, 95% CI = 1.78 to 4.77, P < .001). Conclusions Bupropion SR was effective in promoting smoking cessation during the medication phase of treatment but showed no effect on long-term smoking cessation among African American light smokers. More research is needed to identify strategies for sustaining abstinence among African American light smokers. [ABSTRACT FROM PUBLISHER]

Background: American Indians (AI) have the highest smoking rates of any ethnic group in the US (40.8%), followed most closely by African Americans (24.3%) and European Americans (23.6%). AI smokers also have more difficulty quitting smoking compared to other ethnic groups, evidenced by their significantly lower quit ratios, and are among the least successful in maintaining long term abstinence. While health disparities like these have existed for years among AI, the epidemiology of smoking and nicotine dependence has not been optimally described among this underserved population. Our overarching hypothesis is that the susceptibility of AI to cigarette smoking and nicotine dependence and its consequences has both an underlying nicotine metabolism component as well as psychosocial, cultural, and environment causes. We are well-positioned to explore this issue for the first time in this population. Our objective is to establish a cohort of AI tribal college/university students to determine the predictors of smoking initiation (non-use to experimentation), progression (experimentation to established use), and cessation (established use to cessation). Much of what is known about the process of smoking initiation and progression comes from quantitative studies with non-Native populations. Information related to smoking use among AI tribal college/university (TCU) students is entirely unknown and critically needs further investigation. This study will be the first of its kind among AI college students who are at the highest risk among all ethnic groups for tobacco dependence. Methods/design: First year students at Haskell Indian Nations University in Kansas will be recruited over four consecutive years and will be surveyed annually and repeatedly through year 5 of the study. We will use both longitudinal quantitative surveys and qualitative focus group methods to examine key measures and determinants of initiation and use among this high risk group. [ABSTRACT FROM AUTHOR]

Aim Approximately 50% of African American smokers are light smokers (smoke ≤ 10 cigarettes a day). The prevalence of light smoking in the United States is increasing, yet there has not been a single smoking cessation clinical trial targeting light smokers. The purpose of this 2 × 2 factorial, randomized clinical trial was to evaluate the efficacy of nicotine gum (2 mg versus placebo) and counseling (motivational interviewing versus health education) for African American light smokers. Design Participants were assigned randomly to one of four study arms: 2 mg nicotine gum plus health education (HE); 2 mg nicotine gum plus motivational interviewing (MI); placebo gum plus HE; and placebo gum plus MI. Participants and setting A total of 755 African American light smokers (66% female, mean age = 45) were enrolled at a community health center over a 16-month period. Intervention and measurements Participants received an 8-week supply of nicotine gum and six counseling sessions during the course of the 26-week study. Biochemical measures included expired carbon monoxide (CO) and serum and salivary cotinine. Findings Seven-day quit rates for nicotine gum were no better than for the placebo group (14.2% versus 11.1%, P = 0.232) at 6 months. However, a counseling effect emerged, with HE performing significantly better than MI (16.7% versus 8.5%, P < 0.001). These results were consistent across outcome time-points (weeks 1, 8, and 26). Conclusions Results highlight the potential positive impact of directive information and advice-oriented counseling on smoking cessation. Studies are needed to assess other interventions that may further improve quit rates among African American light smokers who are motivated to quit. [ABSTRACT FROM AUTHOR]